99mTc-MIBI Scintigraphy Versus 131I Whole Body Scan in the Follow-up of Patients with Differentiated Thyroid Carcinoma

2006 ◽  
Vol 6 (5) ◽  
pp. 806-811
Author(s):  
Dabiri Sh. .
2009 ◽  
Vol 53 (7) ◽  
pp. 874-879 ◽  
Author(s):  
Maria Eduarda Mello ◽  
Rodrigo C. Flamini ◽  
Rossana Corbo ◽  
Marcelo Mamede

The radioactive iodine has been used with great value as a diagnostic and therapeutic method in patients with differentiated thyroid carcinoma previously submitted to total thyroidectomy. False-positive whole-body scans may occur due to misinterpretation of the physiologic distribution of the radioisotope or lack of knowledge on the existence of other pathologies that could eventually present radioiodine uptake. Thymic uptake is an uncommon cause of false-positive whole-body scan, and the mechanism through which it occurs is not completely understood. The present paper reports five cases of patients with differentiated thyroid cancer who presented a mediastinum uptake of radioiodine in a whole-body scan during follow-up. The patients had either histological or radiological confirmation of the presence of residual thymus gland. It is very important to know about the possibility of iodine uptake by the thymus in order to avoid unnecessary treatment, such as surgery or radioiodine therapy.


2020 ◽  
Author(s):  
Angela Spanu ◽  
Susanna Nuvoli ◽  
Andrea Marongiu ◽  
Ilaria Gelo ◽  
Luciana Mele ◽  
...  

Abstract Background: The identification of neck lymph node (LN) metastases represents a very important issue in the management of patients with differentiated thyroid carcinoma (DTC). To this purpose, in the present study, we used 131I-SPECT/CT as a diagnostic imaging procedure. Methods: A consecutive series of 224 DTC patients with ascertained neck radioiodine-avid foci at ¹³¹I-SPECT/CT during long-term follow-up was evaluated. All patients had already undergone total thyroidectomy and radioiodine therapy and had been classified as follows: 62 at high risk (H), 64 at low risk (L) and 98 at very low risk (VL). ¹³¹I-Whole body scan (WBS) followed by SPECT/CT was performed in all cases. Results: In the 224 patients, 449 neck iodine avid foci were ascertained at SPECT/CT, while 322 were evidenced at WBS in 165/224 patients. WBS classified as residues 263/322 foci and as unclear 59/322 foci; among the former foci SPECT/CT correctly characterized 8 LN metastases and 3 physiologic uptakes and among the latter, it pinpointed 26 LN metastases, 18 residues, and 15 physiologic uptakes. SPECT/CT also classified 127 foci occult at WBS as 59 LN metastases and 68 residues. Globally, SPECT/CT identified 93 LN metastases in 59 patients (26 H, 20 L, 13 VL), while WBS evidenced 34 in 25 cases. All 13 VL patients, T1aN0M0, 5 of whom with LN near sub-mandibular glands, had thyroglobulin undetectable or <2.5 ng/ml. Globally, SPECT/CT obtained an incremental value than WBS in 45.5 % of patients, a more correct patient classification changing therapeutic approach in 30.3 % of cases and identified WBS false-positive findings in 8% of cases. Conclusions: ¹³¹I-SPECT/CT proved to correctly detect and characterize neck LN metastases in DTC patients in long-term follow-up, improving the performance of planar WBS. SPECT/CT routine use is thus suggested; its role is particularly relevant in patients with WBS inconclusive, VL, T1aN0M0 and with undetectable or very low thyroglobulin levels. Keywords: Differentiated thyroid carcinoma (DTC), Neck lymph node metastases, Long-term follow-up, 131I-Whole body scan (WBS), 131I-SPECT/CT


2020 ◽  
Author(s):  
Angela Spanu ◽  
Susanna Nuvoli ◽  
Andrea Marongiu ◽  
Ilaria Gelo ◽  
Luciana Mele ◽  
...  

Abstract Background: The prognostic importance of neck lymph node (LN) metastases in differentiated thyroid carcinoma (DTC) is controversial even if their presence at surgery often correlates with tumor recurrences that it is mandatory to identify. To this purpose, in the present study, we used 131I-SPECT/CT as a diagnostic imaging procedure. Methods: We retrospectively evaluated 224 consecutive DTC patients already submitted to total thyroidectomy and radioiodine therapy, all of them with ascertained neck radioiodine-avid foci at ¹³¹I-SPECT/CT during long-term follow-up; at surgery, 62 patients were classified at high risk (H), 64 at low risk (L) and 98 at very low risk (VL). All patients underwent ¹³¹I-Whole body scan (WBS) followed by SPECT/CT. Results: In the 224 patients, 449 neck iodine avid foci were ascertained at SPECT/CT, while 322 were evidenced at WBS in 165/224 patients. WBS classified as residues 263/322 foci and as unclear 59/322 foci; among the former foci SPECT/CT correctly characterized 8 LN metastases and 3 physiologic uptakes and among the latter, it pinpointed 26 LN metastases, 18 residues, and 15 physiologic uptakes. SPECT/CT also classified 127 foci occult at WBS as 59 LN metastases and 68 residues. Globally, SPECT/CT identified 93 LN metastases in 59 patients (26 H, 20 L, 13 VL), while WBS evidenced 34 in 25 cases. All 13 VL patients, T1aN0M0, 5 of whom with LN near sub-mandibular glands, had thyroglobulin undetectable or <2.5 ng/ml. Globally, SPECT/CT obtained an incremental value than WBS in 45.5 % of patients, a more correct patient classification changing therapeutic approach in 30.3 % of cases and identified WBS false-positive findings in 8% of cases. Conclusions: ¹³¹I-SPECT/CT proved to correctly detect and characterize neck LN metastases in DTC patients in long-term follow-up, improving WBS performance. SPECT/CT routine use is suggested; its role is particularly significant in patients with WBS inconclusive, VL, T1aN0M0 and with undetectable or very low thyroglobulin levels. Keywords: Differentiated thyroid carcinoma (DTC), Neck lymph node metastases, Long-term follow-up, 131I-Whole body scan (WBS), 131I-SPECT/CT


1983 ◽  
Vol 104 (3) ◽  
pp. 327-332 ◽  
Author(s):  
M. Hüfner ◽  
H. P. Stumpf ◽  
M. Grussendorf ◽  
H.J. Hermann ◽  
B. Kimmig

Abstract. In 68 patients with proved metastases of differentiated thyroid carcinoma the comparative value of the 131I whole body scan and plasma Tg measurements in establishing the diagnosis of metastasis or recurrence was analyzed retrospectively. At the time of primary therapy most metastases were diagnosed by the post-therapy scan (78%). Eight of 9 scintigraphic negative metastases in the post-therapy scan were indicated by elevated Tg levels (> 10 ng/ml). Twenty-four of 28 recurrences after a disease free interval were negative in the 2 mCi 131I scan, 18 of these patients were Tg positive. Of the 4 recurrences with positive 131I uptake all were Tg positive; two of them only during endogenous TSH stimulation. It is conlcuded that the routine 2 mCi whole body scan is less efficient in follow-up than is generally assumed. The most important follow-up parameter for these patients is the plasma Tg which can be obtained under suppressive therapy if a sensitive assay is used. In patients with a negative post-therapy scan and a negative Tg (< 5 ng/ml) it seems justified to omit further 131I whole body control scans as long as Tg remains negative.


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